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Pituitary Apoplexy Following Severe Diabetic Ketoacidosis, With Two Uncommon Complications of Supraventricular Tachycardia and Acute Limb Ischemia in a Patient with Neglected Pituitary Adenoma and Undiagnosed Diabetes Mellitus: A Rare Clinical Association

Pituitary apoplexy (PA) is a clinical emergency arising from acute ischemia or hemorrhage of the pituitary gland. A small subset of pituitary adenomas present with an apoplectic crisis, with common symptoms being headache, nausea/vomiting, visual impairment, ophthalmoplegia, altered sensorium, panhy...

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Autores principales: Pattankar, Sanjeev, Chauhan, Phulrenu, Kapadia, Farhad, Sankhe, Milind
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Thieme Medical and Scientific Publishers Pvt. Ltd. 2022
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9298583/
https://www.ncbi.nlm.nih.gov/pubmed/35873842
http://dx.doi.org/10.1055/s-0042-1748833
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author Pattankar, Sanjeev
Chauhan, Phulrenu
Kapadia, Farhad
Sankhe, Milind
author_facet Pattankar, Sanjeev
Chauhan, Phulrenu
Kapadia, Farhad
Sankhe, Milind
author_sort Pattankar, Sanjeev
collection PubMed
description Pituitary apoplexy (PA) is a clinical emergency arising from acute ischemia or hemorrhage of the pituitary gland. A small subset of pituitary adenomas present with an apoplectic crisis, with common symptoms being headache, nausea/vomiting, visual impairment, ophthalmoplegia, altered sensorium, panhypopituitarism, etc. Though diabetic ketoacidosis (DKA) is an established complication of uncontrolled diabetes mellitus, its association with PA is extremely rare. Likewise, supraventricular tachycardia (SVT) and acute limb ischemia (ALI) have rare, reported association with DKA. We present one such case of rare associations seen in our clinical practice. A 20-year-old woman was brought to our emergency room with headache, breathlessness, and altered sensorium. Clinical and biochemical evaluation revealed SVT, DKA, and right lower limb ALI. On enquiry, patient was found to be diagnosed with pituitary adenoma 2 years ago and lost to follow-up. PA was detected on neuroimaging and confirmed histopathologically. Possibility of PA presenting as DKA and its sequelae exists.
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spelling pubmed-92985832022-07-21 Pituitary Apoplexy Following Severe Diabetic Ketoacidosis, With Two Uncommon Complications of Supraventricular Tachycardia and Acute Limb Ischemia in a Patient with Neglected Pituitary Adenoma and Undiagnosed Diabetes Mellitus: A Rare Clinical Association Pattankar, Sanjeev Chauhan, Phulrenu Kapadia, Farhad Sankhe, Milind Asian J Neurosurg Pituitary apoplexy (PA) is a clinical emergency arising from acute ischemia or hemorrhage of the pituitary gland. A small subset of pituitary adenomas present with an apoplectic crisis, with common symptoms being headache, nausea/vomiting, visual impairment, ophthalmoplegia, altered sensorium, panhypopituitarism, etc. Though diabetic ketoacidosis (DKA) is an established complication of uncontrolled diabetes mellitus, its association with PA is extremely rare. Likewise, supraventricular tachycardia (SVT) and acute limb ischemia (ALI) have rare, reported association with DKA. We present one such case of rare associations seen in our clinical practice. A 20-year-old woman was brought to our emergency room with headache, breathlessness, and altered sensorium. Clinical and biochemical evaluation revealed SVT, DKA, and right lower limb ALI. On enquiry, patient was found to be diagnosed with pituitary adenoma 2 years ago and lost to follow-up. PA was detected on neuroimaging and confirmed histopathologically. Possibility of PA presenting as DKA and its sequelae exists. Thieme Medical and Scientific Publishers Pvt. Ltd. 2022-06-01 /pmc/articles/PMC9298583/ /pubmed/35873842 http://dx.doi.org/10.1055/s-0042-1748833 Text en Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Pattankar, Sanjeev
Chauhan, Phulrenu
Kapadia, Farhad
Sankhe, Milind
Pituitary Apoplexy Following Severe Diabetic Ketoacidosis, With Two Uncommon Complications of Supraventricular Tachycardia and Acute Limb Ischemia in a Patient with Neglected Pituitary Adenoma and Undiagnosed Diabetes Mellitus: A Rare Clinical Association
title Pituitary Apoplexy Following Severe Diabetic Ketoacidosis, With Two Uncommon Complications of Supraventricular Tachycardia and Acute Limb Ischemia in a Patient with Neglected Pituitary Adenoma and Undiagnosed Diabetes Mellitus: A Rare Clinical Association
title_full Pituitary Apoplexy Following Severe Diabetic Ketoacidosis, With Two Uncommon Complications of Supraventricular Tachycardia and Acute Limb Ischemia in a Patient with Neglected Pituitary Adenoma and Undiagnosed Diabetes Mellitus: A Rare Clinical Association
title_fullStr Pituitary Apoplexy Following Severe Diabetic Ketoacidosis, With Two Uncommon Complications of Supraventricular Tachycardia and Acute Limb Ischemia in a Patient with Neglected Pituitary Adenoma and Undiagnosed Diabetes Mellitus: A Rare Clinical Association
title_full_unstemmed Pituitary Apoplexy Following Severe Diabetic Ketoacidosis, With Two Uncommon Complications of Supraventricular Tachycardia and Acute Limb Ischemia in a Patient with Neglected Pituitary Adenoma and Undiagnosed Diabetes Mellitus: A Rare Clinical Association
title_short Pituitary Apoplexy Following Severe Diabetic Ketoacidosis, With Two Uncommon Complications of Supraventricular Tachycardia and Acute Limb Ischemia in a Patient with Neglected Pituitary Adenoma and Undiagnosed Diabetes Mellitus: A Rare Clinical Association
title_sort pituitary apoplexy following severe diabetic ketoacidosis, with two uncommon complications of supraventricular tachycardia and acute limb ischemia in a patient with neglected pituitary adenoma and undiagnosed diabetes mellitus: a rare clinical association
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9298583/
https://www.ncbi.nlm.nih.gov/pubmed/35873842
http://dx.doi.org/10.1055/s-0042-1748833
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